Register for VBS

Family Information

Primary Phone

Alternate Phone

Address

Emergency Contact

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Student Information

Participants must be aged 4 - entering 5th grade (10) and independently potty-trained. Groups will be made based off of age and grade level, with special requests taken into consideration but not guaranteed. We do request that you only register if you are able to attend all 5 days, since we plan for your child to be there.

Gender

Birth Date

Age Group

Shirt Size

Food Allergies

Details

Medical Concerns

Details

Photo Consent Form I consent to my child's photograph being used on Bell Creek's website or Facebook. There is also a slideshow of the week shown the last day of VBS; however, we do not post it anywhere.

I have more students to register